Ambulance cover in Victoria

What is ambulance cover?

Ambulance cover is a type of health insurance that reimburses policyholders for all or part of the costs of receiving ambulance services. Ambulance services are not covered by Medicare, but in some states and territories in Australia, ambulance services are funded by the state or territory government. In other parts of the country – including Victoria – users are generally required to pay for ambulance services, and may want to consider a level of ambulance cover to protect themselves financially if they need an ambulance.

Health insurance cover for ambulance services can take a few different forms. Some health insurers offer a standalone ambulance cover product, whereas others simply cover ambulance costs under their hospital or extras products.

An ambulance policy will typically only cover you for costs associated with ambulance transport and paramedic treatment. Once the ambulance gets you to the hospital, however, that’s where this type of health insurance cover ends. You may want to consider having a broader level of health insurance to help cover you for any further costs you may incur at the hospital.

Related story: Will health insurance or Medicare cover emergency medical costs?

How do I get ambulance cover for Victoria?

There are a couple of ways you can get covered for the cost of ambulance services in VIC:

• become a member of Ambulance Victoria, or;
• take out a private health insurance policy.

Membership of Ambulance Victoria

Victorians wanting cover for ambulance services can apply for membership of Ambulance Victoria. At the time of writing, the membership fee is $53.37 for a single person (or $13.34 quarterly if paid by direct debit).The fee for a family is $106.73 (or $26.68 per quarter if paid by direct debit).

Ambulance Victoria says its membership includes:

• Emergency road ambulance transport
• Mobile Intensive Care Ambulance attendance and treatment
• Emergency air ambulance and clinically necessary non-emergency air ambulance
• Ambulance treatment when transport is not required
• Clinically necessary non-emergency patient transport

Private health insurance ambulance-only cover

Eligible private health ambulance-only policies are designed to cover policyholders for the cost of ambulance services in Victoria. Depending on the policy, it may cover:

• emergency ambulance services only (transport and any paramedic care provided), or;
• both emergency and non-emergency services up to the limits specified under the policy.

Policies may also apply within the state of VIC only or Australia-wide. Ambulance cover typically only applies to ambulance services by the recognised state-based provider (i.e. Ambulance Victoria).

Some of considerations to watch out for when taking out an ambulance policy include:

• Does the policy cover ambulance services over air and sea or just road?
• Are there any limits on how much you can claim within a set period?
• What waiting periods apply between the time you take out the policy and when you can make a claim, bearing in mind that the waiting periods may be different for emergency and non-emergency cover?
• Does the policy the cost of transport to or from private hospitals or clinics.

It’s important to keep in mind that ambulance cover only applies to the cost of services provided by the ambulance service and generally does not cover care you receive at the hospital.

Private health insurance hospital or extras policy with ambulance cover

If you would prefer to be covered for ambulance services in Victoria as part of a broader health insurance policy, you could consider a hospital and/or extras policy that includes a level of ambulance cover. If you already have health insurance in place, consider checking whether ambulance cover is included and to what level (e.g. does it cover emergency and non-emergency ambulance services, and just in VIC or nationally?).

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How do ambulance services work for residents of Victoria?

Ambulance services in VIC are provided by Ambulance Victoria. This includes emergency transport and treatment via road and air, as well as non-emergency transport in some situations.

What are the fees for ambulance services in VIC?

Unless you are eligible for a concession (or have ambulance cover), Victorian residents generally have to pay for ambulance services they use. The fees differ according to what type of assistance the patient needs, how they will be transported, where the patient is located and where they need to be transported. At the time of writing, the fees (excluding GST) are as follows, according to the Victoria Department of Health:

Emergency road transport fees

• Metropolitan: $1396
• Regional and rural: $2059

Non-emergency road transport fees

• Metropolitan: $377 (stretcher*), $124 (clinic car)
• Regional and rural: $637 (stretcher only)

Stretcher patients may be “low, medium or high acuity and require treatment, monitoring, observation or supervision during transport”, according to Ambulance Victoria.

Cases with a final priority of five or greater are charged at non-emergency rates.

Treatment without transport

• Metropolitan, regional and rural: $602

Air transport (emergency and non-emergency)

• Fixed wing transport (fixed charge): $3347
• Fixed wing transport (variable charge): $2475
• Rotary (helicopter) transport (fixed charge): $29,635
• Rotary transport (variable charge): $12,449

Are there any concessions or exemptions from paying for ambulance services in VIC?

According to Ambulance Victoria, eligible Victorians holding certain concession cards receive free clinically necessary ambulance coverage throughout Australia, with transport provided to the nearest and most appropriate medical facility.

Concession classifications include:

• current Victorian Pensioner Concession cardholders (includes dependent children listed on the card but not spouses)
• current Health Care Card holders and their eligible dependents (does not include Health Care Card for carer allowance and foster care issued in the name of the child)
• children holding a current Child Disability Health Care Card or Foster Child Health Care Card, but not their guardians/families listed on the card
• a child under a Family reunification, Care by Secretary or Long-term care order including children on interim accommodation orders
• a person who is subject to an order under the Mental Health Act 2014, Sentencing Act 1991, or Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 requiring them to be compulsorily assessed or treated in a designated mental health service. This includes compulsory, security and forensic patients.
• eligible asylum seekers

More information on eligibility criteria, exclusions and other details are available from Ambulance Victoria.

In addition, Ambulance Victoria says it offers a compassionate exemption from the cost of ambulance services in the following circumstances:

• Required an ambulance following a sexual assault, domestic violence or child abuse;
• Was a deceased child under the age of 18 years.
• Was a member of Victoria’s emergency services who, while on duty, required treatment without transport services.

Am I covered for ambulance assistance or transport outside Victoria?

Some other states and territories charge those who receive ambulance services for all or part of the cost. However, Victorians who are members of Ambulance Victoria are eligible to receive the same benefits while they are interstate that they would have received if they had been in Victoria. This extends to children listed on a family membership who are studying interstate.

If you have private health insurance with ambulance cover, consider checking whether your policy covers you for ambulance services Australia-wide or only within Victoria.

If you are overseas, you will generally need travel insurance in order to be covered for medical costs, such as ambulance fees, incurred during your trip.

What happens if I can’t pay for ambulance services in VIC?

Ambulance Victoria says people facing genuine difficulty can apply for hardship consideration. If you’re having difficulty or you believe that your invoice should be considered for compassionate exemption, Ambulance Victoria encourages consumers to contact it on 1800 990 029 for a confidential conversation.

Are visitors to Victoria covered for ambulance services?

Residents of other states may be liable to pay for the cost of receiving ambulance services in Victoria, unless they:

• have an adequate level of private health insurance;
• their costs are covered by their own state government (as is the case for Queensland residents, for example), or;
• if they are a member of their state ambulance service and it covers them for services received in other states.

Consider checking with your private health insurer, state government or state ambulance service to see whether you are covered.

Residents of certain parts of New South Wales and South Australia within Ambulance Victoria’s ‘Operational Boundaries’ are eligible to become members of Ambulance Victoria.

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Main image source: Nils Versemann (shutterstock.com)